Is aggressive care appropriate for patients with cancer complicated by pneumonia? A retrospective chart review in a tertiary hospital

BMC Palliative Care

Research

Patama Gomutbutra¹  Chanchanok Aramrat¹  Thawalrat Ratanasiri² 

[1] Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Tambon Sriphum, Muang District, 50200, Chiang Mai, Thailand;Karunruk Palliative Care Center, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, 123 Mittraphap Road, Tambon Nai-Muang, Muang District, 40002, Khon Kaen, Thailand;

关键词: Cancer;    Pneumonia;    In-hospital mortality rate;    Prognosis;    Lymphocyte;    Oxygen pulse;   

DOI  :  10.1186/s12904-023-01127-2

 received in 2022-05-29, accepted in 2023-01-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPneumonia in cancer patients is often problematic in order to decide whether to admit and administer antibiotics or pursue a comfort care pathway that may avoid in-hospital death. We aimed to identify factors which are easily assessed at admission in Thailand’s healthcare context that could serve as prognostic factors for in-hospital death.MethodsRegression analysis was utilized to identify the prognostic factors from clinical factors collected at admission. The primary outcome was in-hospital death. Data was collected from the electronic medical records of Chiang Mai University Hospital, Thailand, from 2016 to 2017. Data on adult cancer patients admitted due to pneumonia were reviewed.ResultsIn total, 245 patients were included, and 146 (59.6%) were male. The median age of the patients was 66 years (IQR: 57–75). A total of 72 (29.4%) patients died during admission. From multivariate logistic regression, prognostic factors for in-hospital death included: Palliative Performance Scale (PPS) ≤ 30 (OR: 8.47, 95% CI: 3.47–20.66), Palliative Performance Scale 40–50% (OR: 2.79, 95% CI: 1.34–5.81), percentage of lymphocytes ≤ 8.0% (OR: 2.10, 95% CI: 1.08–4.08), and pulse oximetry ≤ 90% (OR: 2.01, 95% CI: 1.04–3.87).ConclusionThe in-hospital death rate of cancer patients admitted with pneumonia was approximately 30%. The PPS of 10–30%, PPS of 40–50%, percentage of lymphocytes ≤ 8%, and oxygen saturation < 90% could serve as prognostic factors for in-hospital death. Further prospective studies are needed to investigate the usefulness of these factors.

【 授权许可】

CC BY   
© The Author(s) 2023

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